//fpnotebook.com/
Specialized Nutrition Support
Aka: Specialized Nutrition Support, Nutrition Support
- Evaluation
- See Subjective Global Assessment of Nutritional Status
- See Lab Markers of Malnutrition
- Indications
- No food intake secondary to underlying condition (adjusted for malnourishment at baseline)
- Adults: 5-7 days
- Children: 3-5 days
- Infants: 1-3 days
- Specific conditions
- Impaired bowel function (e.g. short bowel syndrome)
- Severe prolonged hypercatabolic state
- Severe protein-calorie Malnutrition (due to a treatable condition)
- Prolonged bowel rest (e.g. Inflammatory Bowel Disease exacerbation)
- Types
- Enteral Nutrition
- Prefererred form of nutritional support
- Peripheral Parenteral Nutrition (PPN)
- Total Parenteral Nutrition (TPN)
- Evaluation: Nutritional requirements
- Calories
- Adults: 25-35 kcal/kg/day
- Child >5 years: 1500 kcal/day for weight of 20kg, then 25 kcal/day per each additional kg above 20 kg
- Protein
- Adults: 0.8 to 1.5 g/kg/day
- All Children and infants, as well as those adults in hypercatabolic or protein losing states require higher protein intake
- Linoleic Acid
- Dose: 2-4% of total calories should be in this form to prevent essential Fatty Acid deficiency
- Prcautions
- Refeeding Syndrome risk
- Start refeeding at one third or less of nutritional needs and gradually increase every 5-7 days
- References
- Kulick (2011) Am Fam Physician 83(2): 173-83 [PubMed]